Li Chenghui, Peng Cheng, DelNero Peter, Laryea Jonathan, Ramirez Aguilar Daniela, Koru Güneş, Park Yong-Moon Mark, Saini Mahima, Schootman Mario
Division of Pharmaceutical Evaluation and Policy, Department of Pharmacy Practice, University of Arkansas for Medical Sciences College of Pharmacy, Little Rock, AR, USA.
Department of Internal Medicine, University of Arkansas for Medical Sciences College of Medicine, Little Rock, AR, USA.
Cancer Causes Control. 2025 Jan;36(1):27-44. doi: 10.1007/s10552-024-01918-9. Epub 2024 Sep 22.
We aimed to (1) determine the extent of coverage of colorectal cancer patients in Arkansas All-Payer Claims Database (APCD), (2) assess coverage difference between persistent poverty and other areas, and (3) identify patient, tumor, and area factors associated with inclusion in APCD.
Data were from 2018 to 2020 Arkansas APCD linked with 2019 Arkansas Central Cancer Registry (ACCR). We constructed four cohorts to assess APCD's coverage of CRC patients: (Cohort 1) ≥ 1 day of medical coverage in APCD in 2019; (Cohort 2) APCD coverage in the diagnosis month; continuous APCD coverage in the 30; Year around diagnosis (six months before to five months after diagnosis month) (Cohort 3); or until death within six months (Cohort 4). We compared proportions in the cohorts by area persistent poverty designation. Logistic regressions identified factors associated with inclusion in APCD cohorts.
CRC patients diagnosed in 2019 from ACCR, excluding in situ disease.
Of the 1,510 CRC patients diagnosed in 2019, 83% had ≥ 1 day of medical coverage in 2019 APCD (Cohort1), 81% had coverage in the diagnosis month (Cohort 2), and 63% had continuous coverage in the year around diagnosis (Cohort 3). Additionally, 11% died within six months but had continuous coverage until death (Cohort 4, 74%). No coverage difference was found between persist poverty and other areas. Age and primary payer type at diagnosis were the main predictors of inclusion in APCD.
Arkansas APCD had high coverage of Arkansas CRC patients. No selection bias by area of persistent poverty designation was present.
我们旨在（1）确定阿肯色州全支付方索赔数据库（APCD）中结直肠癌患者的覆盖范围，（2）评估持续贫困地区与其他地区之间的覆盖差异，以及（3）确定与纳入APCD相关的患者、肿瘤和地区因素。
数据来自2018年至2020年与2019年阿肯色州中央癌症登记处（ACCR）相关联的阿肯色州APCD。我们构建了四个队列来评估APCD对CRC患者的覆盖情况：（队列1）2019年在APCD中有≥1天的医疗覆盖；（队列2）诊断月份的APCD覆盖；诊断月份前后30天的连续APCD覆盖（队列3）；或在六个月内直至死亡（队列4）。我们按地区持续贫困指定比较了队列中的比例。逻辑回归确定了与纳入APCD队列相关的因素。
2019年从ACCR诊断出的CRC患者，不包括原位疾病。
在2019年诊断出的1510例CRC患者中，83%在2019年APCD中有≥1天的医疗覆盖（队列1），81%在诊断月份有覆盖（队列2），63%在诊断前后一年有连续覆盖（队列3）。此外，11%在六个月内死亡，但直至死亡都有连续覆盖（队列4，74%）。持续贫困地区与其他地区之间未发现覆盖差异。年龄和诊断时的主要支付方类型是纳入APCD的主要预测因素。
阿肯色州APCD对阿肯色州CRC患者的覆盖率很高。不存在按持续贫困地区指定的选择偏倚。
